NEW STUDENT FORMS

Health history & immunization forms

The State of Oregon and Oregon State University require the submission of a completed health history form and proof of specific vaccinations, or proof of immunity. Please download the form that applies to you below, complete it electronically and fax it to Student Health Services at 541-737-9665.

Student health history form (PDF)

International student health history form (PDF)

College of Veterinary Medicine health history form

Upon admission to OSU College of Veterinary Medicine, this form must be completed and submitted to receive medical clearance. This form is in addition to the general health history form you must complete before your first term at OSU, and is just one part of the required documentation for Veterinary Medicine students (Word doc).

College of Veterinary Medicine Health History Form (Word doc)

RELEASE OF INFORMATION FORMS

Medical record Release of Information form

You may receive a copy of your records, or you may have a copy forwarded to your personal healthcare provider, by completing the Consent/Authorization to Disclose Medical Records form. You may also use this form to request immunization records from a prior school or clinic to satisfy the OSU requirements.

Consent/Authorization to Disclose Medical Records form (PDF)

 

CAPS ROI form

A specific release allowing for sharing of information between OSU Counseling and Psychological Services (CAPS), and Student Health Services. Please initial all appropriate areas.

CAPS Consent/Authorization to Disclose Medical Records form (PDF)

 

CAPS BLEND ROI form

This is a form allowing for OSU Counseling and Psychological Services (CAPS) and Student Health services to share information specifically for nutritional information with OSU's Body Image Lifestyle Choices Exercise Nutrition Disordered Eating (BLEND) team. Please initial all appropriate areas.

CAPS Consent/Authorization to Disclose Medical Records BLEND (PDF)

MISCELLANEOUS FORMS

Advance directive form

An advance directive is a set of instructions that explain the specific health care measures a person wants if he or she should have a terminal illness or injury and become incapable of indicating whether to continue curative and life-sustaining treatment, or to remove life support systems.

Advance Directive Form (PDF)